Measuring Success on Impact, Not Profit

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I recently volunteered during a startup competition. As a third party, I had a bird’s-eye view into the health care solutions that were being proposed. Solution after solution emphasized profitability over patient experience and business viability rather than population health.  At least one of these solutions was chosen as a winner of the competition.  In any other industry, it would make sense for these considerations to be prioritized and rewarded.  But this is health care.  We aren’t just dealing with individuals and their families. We are dealing with issues of life and death.

I’ve worked within the 5 Points of Health Care™ for nearly 15 years.  Before accepting my role with Cambia Grove, I was skeptical about the impact that certain kinds of innovation could have on the health care system.  I had seen too many examples where the main driver was personal financial gain.  And I’ve seen this theme reinforced further by funders, accelerators, and even customers.  

From my former vantage points within payer and provider organizations, I could see where individuals were profiting off a broken system. Creating solutions to problems that didn’t exist. Or worse, creating solutions to existing problems that add costs to the system rather than removing them, create a more disjointed patient experience, or have little or no positive impact on health.

But it doesn’t have to be this way. We created the Health Care Innovation Advancement Framework to fundamentally shift the way we think about health care innovation.  

First, the Advancement Framework lays out the kind of innovation we want to see.  We want to see a health care system that is person-focused and economically sustainable.

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We want to achieve the Triple Aim of lowering per capita cost, improving patient experience, and improving population health.  And we believe that the right kind of innovation, impactful innovation, can get us there.  

Unfortunately, as it stands, our domestic health care system is not set up to adopt impactful innovation at scale.  When investigating why potentially impactful innovations fail, we hear a wide variety of explanations ranging from “we don’t have access to enough data” or “nobody will pay for it” or “the system is resistant to change”.  All of these challenges can be true at the same time, and often, all need to be addressed simultaneously for any one of them to improve. 

As we dug into these seemingly infinite barriers, we realized that what we were hearing was simple:

we must optimize three key elements of health care innovation ecosystems - - infrastructure, incentives and culture - - to support widespread adoption of impactful innovation.

We must create the foundational infrastructure necessary for improvement.  We must align incentives with health. And we must develop a culture of equitable change. In doing so, we will create a playing field where health care innovators are supported in creating solutions that put people at the center.  

Let’s picture this health care innovation ecosystem of the future. The digital infrastructure is in place to support the free flow of health data. Providers, payers and purchasers align their incentives to support an individual’s lifetime of health.  And all stakeholders have created a culture that centers health equity.

As anyone who has spent time deep inside the health care system could understand, this is a massive undertaking.  But we know the intended outcome of a person-focused and economically sustainable health care system is well-worth the effort.  We also know that we can’t do it alone. Our state-specific reports apply the Advancement Framework and call on communities to continue aligned efforts while also taking tangible new steps where needed to create stronger ecosystems.   We invite you to join us in this important and exciting work.

 

About Julie Anderson

Director of Strategic Initiatives

Julie joined Cambia Grove in January 2018 to lead the creation and implementation of the Solutions Lab, an initiative built upon the idea that the community has all the right ingredients to solve big system-wide health care challenges. The Solutions Lab convenes stakeholders around high-priority topics, identifies challenges and opportunities, and catalyzes solutions to support system-wide transformation. 

Prior to joining Cambia Grove, Julie she spent more than 5 years with Blue Shield of California driving cross-organizational collaboration as part of their Accountable Care Organization (ACO) program. As Senior Manager of the ACO Program Development and Innovation team, she drove multi-disciplinary efforts to build transformative new care models and better enable provider networks through improvements in technology enablement and team-based care.

Julie began her career in health care in 2006 in hospital revenue cycle consulting, before pursuing a master’s degree in public health from Johns Hopkins. Later, as a process improvement specialist at Stanford Hospital, she drove Lean/Six Sigma projects across the health system and gained insights into the challenges faced at the provider level. 

Julie tries to be outdoors as much as possible, and is an avid hiker and snowboarder. She and her family love to travel, and attempt to visit at least one new destination each year. She is passionate about health care innovation and transformation, and is thrilled to be a member of the Cambia Grove team.